Black Bean and Sweet Potato Quesadillas

I have had a hard time coming up with savoury recipes that don't include hummus or chickpeas in some form (some people smoke, others abuse chickpea dips, what can I say) but then these utterly delicious and chickpea-free quesadillas came to me in a flash of inspiration. A Pinterest flash that is- always my runner-up source of vegspiration. (Instagram comes first!) They're filled with sweet, spicy, savoury amazingness and topped with a goddamn gorgeous green guacamole. Add the simplicity and I know that this will nick a place as one of my top ten lunch recipes.

Make these for yourself, double the recipe and share with a friend or multiply the ingredients by ten and serve it on the buffet table! You could even prepare these the day before (without grilling them of course) and have them for lunch the next day at work or school! They're best eaten warm so a microwave oven would be a plus but they could absolutely be served cold as well, no problemo.

Hope you enjoy this recipe just as much as I did!

Black Bean and Sweet Potato Quesadillas

Yields: 1 serving

- 1 gluten free brown rice tortilla (or tortilla of your choice, I use BFree wraps)

- 1 small sweet potato (approx. 100 g when peeled)

- 4 tbsp canned black beans, drained and rinsed

- 2 tbsp tomato salsa/sauce

- 1 tbsp vegan sour cream (optional)

- A handful baby spinach leaves

A pinch each of: 

- dried coriander

- cumin

- paprika powder 

- salt

Guacamole:

- 1/2 avocado

- 1/2 tbsp nutritional yeast

- 1 tsp lemon juice

- Salt and pepper to taste

- Dried chili flakes (optional)

How to:

1. Start by making your guacamole: Place all ingredients into a small bowl and blitz with a hand blender a few times. Intuitively, the longer you blend the smoother your guac will be so stop when you've reached the desired consistency. Set aside while you prepare the quesadillas.

2. Peel and slice the sweet potato thinly, then steam or boil the slices until they're soft enough to pierce with a fork. This will take approximately 5-10 minutes.

3. Mash the steamed sweet potato with a fork and spread it out evenly on half of the tortilla.

4. On the layer of sweet potato, divide the black beans evenly and sprinkle with cumin, coriander, salt and paprika powder.

5. Cover the other half of the tortilla with a layer of vegan sour cream mixed with tomato salsa and stick a handful of baby spinach leaves to it. 

6. Fold the tortilla in half and cut in 4 "pizza slices".

7. Grill in a grill pan (or a regular but then it won't be as beautifully charred) for a couple of minutes on each side, top with guacamole and serve!

Is Meat Unhealthy? Part III

When we consider the health impacts of eating meat, cardiovascular disease is the first thing that comes to mind.  Popular diet advocates often hold diametrically opposed views on the role of meat in cardiovascular disease.  Even among researchers and public health officials, opinions vary.  In this post, I'll do my best to sort through the literature and determine what the weight of the evidence suggests.

Ancel Keys and the Seven Countries Study

Ancel Keys was one of the first researchers to contribute substantially to the study of the link between diet and cardiovascular disease.  Sadly, there is a lot of low-quality information circulating about Ancel Keys and his research (1).  The truth is that Keys was a pioneering researcher who conducted some of the most impressive nutritional science of his time.  The military "K ration" was designed by Keys, much of what we know about the physiology of starvation comes from his detailed studies during World War II, and he was the original Mediterranean Diet researcher.  Science marches on, and not all discoveries are buttressed by additional research, but Keys' work was among the best of his day and must be taken seriously.

One of Keys' earliest contributions to the study of diet and cardiovascular disease appeared in an obscure 1953 paper titled "Atherosclerosis: A Problem in Newer Public Health" (2).  This paper is worth reading if you get a chance (freely available online if you poke around a bit).  He presents a number of different arguments and supporting data, most of which are widely accepted today, but one graph in particular has remained controversial.  This graph shows the association between total fat intake and heart disease mortality in six countries.  Keys collected the data from publicly available databases on global health and diet:

Read more »

Carob & Zesty Lime Pancakes with a Chocolate Sauce

Carob & Zesty Lime Pancakes

5 tbsp buckwheat flour

2 tbsp coconut flour

1 tsp baking powder

5 tbsp almond milk

2 tbsp plant-based yoghurt (could sub for more almond milk)

1 chia egg (1 tbsp ground chia seeds mixed with 3 tbsp of water, left to swell for a couple of minutes)

For the lime pancakes:

1/2 tsp wheatgrass (could sub for chlorella/spirulina/matcha)

Zest of one lime

1 tsp freshly squeezed lime juice

1/2 tbsp liquid sweetener of your choice (preferably brown rice syrup as it won't spoil the green colour)

For the carob pancakes:

1/2 tbsp liquid sweetener of your choice (preferably date syrup, as it adds a lovely brown colour to the mix)

1-2 tsp carob powder

How to:
1. Place into a bowl the buckwheat flour, coconut flour and baking powder. Stir well to divide the baking powder evenly throughout the mix.
2. Add in the almond milk, chia egg and yoghurt and mix it all together with a fork.
3. Now, divide the batter into two and place half of it into another bowl.
4. To this bowl, add all of the ingredients for the lime pancakes and stir until smooth. You might have to adjust the amount of wheatgrass to get the green colour you want.
5. To the other bowl, add all of the ingredients for the carob pancakes and once again, stir until smooth.
6. Let the batters rest for a few minutes while preheating a non-stick pan or a regular frying pan with a spoonful of coconut oil to medium heat.
7. Fry spoonfuls of the batter for a few minutes on each side, stack and serve!

Chocolate sauce

2 tbsp peanut flour

1 1/2 tbsp almond milk

1/2 tbsp date  syrup

1 tsp cacao or cocoa powder

How to:
1. Stir all ingredients together in a bowl until smooth. Add more almond milk if needed.
2. Pour on top of your pancake stack and devour immediately!

Rocky Road Fudge

It's nearing December and I hope that you are as excited as I am about the upcoming holiday festivities! Sinatra blasting on the radio, the first snow wrapping everything in a soft blanket of white, the comforting crackling from the fireplace and Christmas decorations as far as the eye can see. But no jolly Christmas without something to munch on, right? Be it hot cocoa, mandarins, gingerbread cookies, christmas candy... Tell me if you're drooling yet because I sure am.

If you're one of those people that claim to not like this time of the year (do they even exist?) then I suggest you stop reading right here. Because from now on, my plan is for this blog to be stuffed with all things Christmas, from saffron treats to rice pudding desserts.  This I can assure you, Yuletide addicts- you won't be disappointed.

So first on the list was Rocky Road Fudge. Way out of my comfort zone to be honest, the only rocky road us Swedish people know of, is the one that leads us home after a few too many shots of our favourite holiday liquor: "snaps". Okay so now I'm rambling but what I wanted to say was that I felt this sudden strong urge to make a batch of this Rocky Road deliciousness after seeing it on Pinterest the other day. Only I wanted a vegan and refined sugar-free yet still delicious fudge. This one ticks all the boxes, I have to say. It's wonderfully rich, soft, chewy and 100% cruelty-free!

Rocky Road Fudge

1 cup tightly packed soft dates

1/4 cup melted cacao butter (could sub for coconut oil but cacao will be MUCH better)

2 tbsp cocoa or cacao powder

1 heaped tbsp carob powder

1/2 cup raw almonds (or nuts of your choice)

1/2 cup dried mulberries

How to:

1. Place your dates, cacao butter, carob powder and cacao powder into a food processor and blend on high until smooth. Stop to scrape down the sides a few times to incorporate all the ingredients properly.

2. Take the mulberries and almonds and put them into the food processor with the chocolate paste that has formed and blitz a few times. You want the nuts to be broken up into big, crunchy chunks, not tiny pieces, so make sure not to blend too much. (As you can see, I did a pretty poor job here ;)

3. Press the fudge out into a small, lined, rectangular baking tray. It might not fill the whole tray but it's firm enough to only fill half of it and still get thick pieces of fudge.

4. Put in the fridge or freezer to set, at least for a couple of hours. Remove from the fridge and cut into squares. Store in the freezer if you want the mulberries to be crunchy! (Hint: you do.)

Have a wonderful day!

Tilda

LIFTING WEIGHTS DOES NOT MAKE ME BULKY

For all the ladies who think you are going to lose your feminine looks by lifting weights, I am here to tell you that it is a myth.  We simply do not have enough testosterone naturally to produce extreme muscle mass.  We do benefit from a firm and tone look produced with weight resistance training and also taking into consideration genetics we were blessed with in combination with a healthy eating program. Our lean mass will provide more shape than anything else and does it show after years of commitment?  The answer is yes, however it will not be substantial enough for us to dash into a phone booth ready to jump out sporting our muscular superwoman outfit. What will be noticed about a committed weight training program are shapely arms, butt, legs and overall fit look and side benefits of feeling great about the compliments received for those attributes. 

I have been lifting weights close to thirty years and do sport a lean muscular physique but do not consider myself bulky.  What allows my muscle to show more is maintaining a lower body fat percentage year round, however I keep that within a healthy range to not screw around with my hormones.  As a woman entering menopause I understand the importance and health benefits of weight bearing exercise.  I enjoy the visual results, but more important, I am making sure my bones remain dense and strong during the decline of estrogen from menopause.  Weight training is prescribed to all women going through this phase and to reduce the risk of osteoporosis and/or osteopenia.  I am genetically lean thanks to my Dad and that is just how I am built, but my body has also responded well to weight training.  Some may think I look bulky, but if you met me in person, you would have a whole different opinion.  Can I flex it up in images, well of course and I have got the back lash of “she is too muscular”, but bulky is not a word that can be used to describe my body.

The health benefits of weight training go beyond what is visible and includes improved bone and joint function, bone density, and increased muscle tendon and ligament strength.  The more lean mass we have, the more efficient our bodies become with burning energy stores and maintaining a healthy weight.  We become healthier overall, and our confidence is boosted when we feel our healthy best. 

The look obtained from weight training is one that exemplifies a healthy lifestyle, not some sort of “she-man” that seems to be running around in everyone’s mind. The media is in the market for distortion of the truth in all areas of fitness with photo shop, air brushing, and the verbal word of weight lifting for girls equals turning into a man.  This is so far from the truth and is laughable.  I believe in being our own health and fitness advocates, putting in the research about subjects such as weight training and doing what is best for our bodies to become a healthier person.  Our female hormones will allow for some increase and sculpting of beautiful muscle and the inward and outward benefits are not only beautiful but we as women should embrace weight training as a very important part of our health programs. 

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DON'T FEAR THE WEIGHTS

Stay Healthy,
Darla

  

Meditation Challenge Update

It's been about two weeks since I wrote in, declaring my intentions for the 21-day meditation with Oprah and Deepak.  The update is I have failed miserably.  Like bad.  In the past 14 days, I have meditated a total of three times.  Yeah.  The challenge started on a Monday, but I began on Tuesday because that's when I got the email linking to the first meditation.  I also meditated on Wednesday and Thursday.  Friday is where I fell off the wagon.  I totally forgot about meditating on the weekend and then into the next week I never got back on the wagon.  Now, I feel too far gone to continue.  

The meditations are only available for 5 days, so I could start back up (having missed some) but I'm so not into it right now. Admitting this to myself and you feels like a big failure, but I would rather be real about my failures than pretend to be someone I'm not.  I hear the negative voices in my head and have to work to let them go.  

I still crave a quiet, still alone time in the morning and will be making an effort to incorporate that more, but I think pulling out my Bible/praying/journaling would be more natural to me than meditating.  

How are you doing with the challenge if you tried it?  If you've stuck with it, I applaud you.  And I hope you are getting something good out of it.  Are you hating me for not continuing?  I feel like a workout partner who quit, leaving you hanging.  And that feels bad.  When it comes to certain things in life, we absolutely have to keep going, whether we feel like it or not.  You have to wake up to feed the crying baby, you have to go to work, you have to take your parents to the doctor, you have to pay the mortgage, you have to meet that deadline.  But, there are other times when it's really okay to let something go. Only YOU can decide what those situations are.  And you have to face the consequences for your decision.  I completely get it if you're disappointed in me or upset or think I'm not good with my word.  I have to live with the fact that I said I was going to do this and I didn't finish.  And I chose to put it out there on the Internet, so it's a public fail.  

I would appreciate your grace, your kindness, your empathy.  The friends who support us when we've let ourselves down are the kind of people we need in our lives.  It's the kind of person I want to be in return.  

My intention for trying the meditations initially was to try to still myself each day so that I could be more present and more peaceful on the inside.  Admitting that I failed makes me feel human, vulnerable, and a little bit brave.  

My Basic Hummus Recipe + Oven-roasted Squash

Happy birthday to me! Or happy belated to be correct, my 18th was this Monday. Yay! I can now... uh, buy beer, vote and (in the best of worlds) get my driver's license. Fun! But what's got me really excited is my birthday presents. Can you tell from the picture below what I got?

You guessed it: CHICKPEAS! My wonderful parents gave me a whole truckload of these gu... Wait a second. I'm just kidding. No offence chickpeas but you don't really make the best birthday presents. Okay so if you still haven't figured it out, I got a camera. A Canon EOS 700D that I know absolutely nothing about and have no idea how to use but still - a camera! C-A-M-E-R-A. Meaning this blog won't be nearly as boring from now on. So onto today's recipe:

There are many things that I've learnt to love since going vegan. Bananas, avocados, bell peppers, tofu bur first and foremost I've come to appreciate the beauty that is a perfectly creamy hummus. Everyone who's been following me on Instagram for a while probably knows that I've got a real sweet tooth and rarely choose savoury food if there is any kind of fruit around. With one exception. Hummus. A thick layer spread on a rice cake and my day is made. Hopefully you all like this recipe as well!

My Basic Hummus Recipe

Yields: 1-2 servings

2/3 cup cooked chickpeas

1 tbsp almond milk (Or olive oil if you want an even creamier texture)

1 tbsp nutritional yeast

1-2 tsp freshly squeezed lemon juice

Salt to taste

Optional: 1/2 tsp Paprika powder 

Blend well!

How to:
1. Place chickpeas in a colander in the sink and rinse to get rid of any excess sliminess from the can.
2. Blend all ingredients in a small bowl using a hand blender. Food processors are not recommended for this recipe.
3. Sprinkle with sesame seeds or drizzle with olive oil. Serve as a condiment to falafels, pita bread dishes, salads or maybe the roasted squash below!

Oven-roasted Herb-rubbed Winter Squash

Yields: 2 servings

1/2 small muscat pumpkin or winter squash of your choice

1 zucchini

1 tbsp olive oil

Herbs such as rosemary, thyme and oregano

Salt and pepper to taste

How to:
1. Pre-heat oven to 225C.
2. Cut your squash into halves and scoop out the seeds and the slimy, stringy things surrounding them. Save the other half of your squash in the fridge, unless you want bigger servings, then go ahead and use both halves.
3. Slice the squash about 1/2-inch thick for each slice and put aside.
4. Cut the zucchini lengthwise and slice in 1/2-inch thick slices.
5. Place the vegetables on a lined baking tray and rub with first olive oil then herbs. Spread out evenly on the tray and rosy in the oven for 20-25 minutes or until the squash is soft enough to pierce with a fork.

Health in Impact Assessments: Opportunities not to be missed

"Health in Impact Assessments: Opportunities not to be missed" is a new joint publication from WHO Europe, EUPHA, and IAIA.

Prospective impact assessment is a consolidated approach for pursuing foresight in policy and decision-making, systematically deployed worldwide. There is consensus that, even in well developed impact assessments, human health is not always covered adequately. Partly as a response, health impact assessment (HIA) has emerged and has been applied in several countries in Europe and beyond. Opinions about the merits of HIA separate from other forms of impact assessment differ. This publication aims to provide a detailed and balanced view on "health in impact assessments". Five key types of impact assessment, namely environmental impact assessment, strategic environmental assessment, social impact assessment, sustainability assessment, and HIA are presented, and four key questions are discussed: How can the various assessments contribute to promoting and protecting human health? How can further integration of health support the various forms of impact assessments? What forms of integration seem advisable? What priorities for further development? This analysis suggests that the potential of impact assessments to protect and promote health is underutilized, and represents a missed opportunity. Ways need to be found to exploit the potential to a fuller extent

This publication is available at: http://www.euro.who.int/health-in-IA

Rising Healthcare Costs: Delayed or Defeated?

Ready, set......

According to this just-published New England Journal article, analysts are still waiting for the twin forces of 1) an improving U.S. economy and 2) higher numbers of newly insured Americans to reignite healthcare inflation.  While the latest data from the Bureau of Economic Analysis (BEA) are conflicting, data from the early part of 2014 suggests that health costs are remaining tame.

What gives?
 
While many Obamacare supporters say this is more evidence of Washington's central-planning genius, author Charles Roehrig notes other factors be at play, namely:

1. The 9 million of 2014's newly insured amounts to 3% of the U.S. population. Their baseline spending was probably half of normal, so the resulting increase would expand the nation's spending by a modest additional 1.5%.  Since this group is younger, it'll likely be less than that.  Their contribution to increasing costs will be harder to detect.

2. What's more, insurance enrollments were finalized relatively late in the year, so these newly insured haven't had much of a chance to give their new benefits an early test-drive.

3. The first quarter of 2014 was an unusually cold winter. The Population Health Blog recalls how freezing temps, wind and snow made for a relaxed day at the clinic. Multiply that across millions of newly as well as long-term insured people, and it adds up.

4. Yes, stupid, it is the economy, which has a strong correlation with healthcare spending. Loss of health insurance thanks to unemployment, declining tax revenues that pressure government insurance programs to limit eligibility as well as benefits, employers' unwillingness to go along with otherwise automatic benefit increases and a general unwillingness of consumers to open their wallets in recessionary times has also added up.

5. Thanks to the expiration of some patents, prescription drug spending moderated.

Bottom line: all of the above are one-time impacts.  The economy's impact and new access to insurance are lasting fundamentals that will not go away. It's too soon to tell what is really going on.
 
The PHB will stay tuned.

STOP PLAYING THE SCALE GAME

Who is guilty?  The scale game starts as innocent accountability of weight loss and then turns into a game of just how much we can get away with.  The fitness program is going great, the weight is coming off at a healthy rate and all of a sudden our thoughts turn to bringing unhealthy food items back into our lives at a more than moderation rate.  We challenge that scale and see how far we can push those numbers because we think there is leeway.  The purpose of obtaining a healthy weight is not to yo-yo back and forth, but to get serious about our health and maintain the lifestyle.  If the scale gets in the way of that, it is time to toss it, especially when the “scale game” derails our health and fitness goals and mental game.

 

 

 

 

We are not kidding anyone but ourselves when we play games with our efforts and what is that saying about what we are doing.  There is no half-way living a healthy life and the expectation of obtaining goals by not giving your best will show not only on the scale, but with how our clothes are fitting, and how we feel overall.  The scale game robs us of what we are trying to accomplish with our health and body, and thinking that it is a way to sneak in what we shouldn’t, well that is just wrong.  Yes, it will let us know that we have gained or lost, but when the purpose is to see how much more crap we can eat, or how much less we can exercise, then I would call that scale abuse. I am all for weighing one time per week for accountability and celebrating maintaining a healthy weight, or weight loss, but put my foot down against the scale game. 

 

Success will never come from games or lack of commitment to your goals.  The results will come from effort, a change in lifestyle, and choices with the food we eat and the exercise that we do on a consistent basis.  The scale has nothing to do with the choices, but will let us know about positive progress in a weight loss program.  It can be a friend or foe depending on how our mental game perceives it and how it is being used.  If the “scale game” is an active part of a health program then it really is not a health program.  It is time to stop the games, dump the scale if necessary, and get on with what we are trying to accomplish with our efforts. 

 

 

 

DON'T MISS MY FREE UPDATES

Thanks for stopping by my Blog, hope you enjoy the content, and if you have not become a follower yet, I would love to see your face on my friend's list, or if you want to receive my free updates, use the button at the right to select your feed preference. I look forward to responding to your comments and appreciate your shares.

Stay Healthy,

Darla

 

 

 

Chocolate 'Cheese'cake

Once again, I've neglected this poor little blog in favour of numerous school assignments threatening to squish me under their weight. Teachers don't care about Instagram, recipes or blogs. Teachers care about incomprehensible theorems, calculators and serving horrible non-vegan food. That's what they do. Plus the lighting this time of the year S-U-C-K-S so I obviously don't have a lot to post at the moment. This being said, I did find the time to do a little baking this weekend and I proudly present to you this Vegan Chocolate "Cheesecake"! The ones I made were miniature versions which means you can enjoy a slice whenever you want to. There's always room for a tiny slice of cake. As far as I'm concerned, there's always room for muh-assive wedges of decadent chocolate cakes of any kind, but mind you, I know everyone doesn't agree. So here we have it, small in size but big in flavour!

(Oh and I know I've been inconsistent with the measurements in this recipe, grams here and cups there. If you don't have access to a kitchen scale, just play it by ear, taste as you go, and I'm sure you'll do just fine!)

Chocolate Cheesecake (No-Bake!)

Filling:

About 15-18 medium sized dates (175g)

1 heaped cup raw cashews, soaked overnight (150 g unsoaked)

1 can full fat coconut milk, chilled overnight in the fridge

1 tbsp coconut oil

3 tbsp cacao or cocoa powder

A pinch of salt (to enhance the chocolate flavour)

Crust:

150 g dried figs

1/4 cup oats

1/4 cup dried mulberries

Chocolate topping:

2 tbsp coconut oil, melted

2 tbsp cacao or cocoa powder

1 tbsp liquid sweetener of your choice

How to:

1. Place the figs and oats in a food processor and blend on high until you have a sticky ball of fig-oat deliciousness.
2. Divide the dough in two parts and press each part out into a non-stick springform pan, about 10 cm/4 inches across. You could also use a bigger cake tin, about 15 cm/6 inches in diameter.
3. Open the can of coconut milk and spoon out the hard, creamy layer that has formed on top, into your food processor/high speed blender along with the rest of the filling ingredients. Save the leftover "water" for smoothies and such, it's packed full of wonderful coconut flavour.
4. Blend on high until silky smooth. Be patient- it takes time. But the more you blend the better your filling will be. Stop now and then to scrape down from the sides if necessary.
5. Once the filling is done, pour it into the springform pan(s) and leave for at least 7 hours to set in the freezer.
6. When the cheesecakes have set, mix the ingredients for the chocolate topping in a small bowl until they're well incorporated. Let the "sauce" cool down a bit before you pour it on top of the cheesecakes, that way you'll prevent a runny, chocolate-y mess from happening.

Let each slice thaw for a few minutes before serving!

Enjoy and have a wonderful day!
Tilda

Health Care Cost Insights and Capitation for the Patient Centered Medical Home (PCMH)

The Population Health Blog finally caught up with the Oct 22/29 "Price, Cost and Competition" issue of JAMA. 

One of the more interesting articles was a Viewpoint editorial on the Patient Centered Medical Home (PCMH). After tut-tuting fee-for-service payment as antithetical to meaningful payment reform, the author admits what the PHB has been saying all along: a global payment that covers all the medical, coordinating as well as non-physician services of the PCMH is tantamount to old fashioned "capitation." As we learned in the 1990s, capitation's unintended consequences are a) signing up too many patients, b) limiting access to primary care and c) over-referring to specialists.  To counter that, the editorial's author suggests the PCMH movement seeks "accountability." 

We'll see about that.

In the meantime, some other interesting articles:

Are "for-profit" hospitals evil?  Not necessarily.....

237 hospitals that converted from not-for-profit to for-profit anytime between 2003 and 2010 were compared to 631 hospitals that had not converted.  Converting hospitals improved their financial margins (practically all were in the red and subsequently became break-even) vs. the comparison group, and did so without increased utilization, restricting access to care, higher death rates or declines in quality for their Medicare patients. Their path to profitability may have been lined by renegotiated commercial insurance contracts, cutting costs or moving non-performing assets off the balance sheet.

Can physician groups become monopolistic? In a word, yes.

Commercial insurance preferred provider organization (PPO) charges for ten types of physician office visits in ten different specialties across 50 states were correlated with a measure of local market dominance dubbed the "Hirschman-Herfindahl Index" (more on that here).  As the HHI index increased, payments also increased, suggesting that as much as additional $3 to $12 in fees for the same services were the result of monopolistic contracting.

Monopolies aside, if docs are in charge vs. the hospitals, can they reduce health care costs?  Also yes.

This study compared average "per-patient expenditures" of physician-owned versus hospital-owned integrated medical groups and independent practice associations in California from 2009 to 2012. Among the 158 groups, 118 were owned by docs; their expenditures were over a thousand dollars less compared to hospital owned groups.  Larger physician groups had higher expenditures than the smaller ones.  More on that in a future post.

Does price transparency help patients chose to spend less?

Over 500,000 insurance plan enrollees had special on-line access to prices for medical services prior to using them.  There were over 250,000 households and of these, approximately 7500 accessed the information. Compared to households that didn't check the information, the price-shoppers seemed to choose cheaper labs (a few dollars per test) and imaging options (about a hundred dollars per test).  In looking at the data, the DMCB suspects some may have also deferred testing by choosing to use them less frequently or not at all.

State of the Art Obesity Management - Keep It Away from Primary Care

In the course of the Population Health Blog's last primary care encounter, a measurement of its height and weight determined that it was overweight.  On the way to the examination room, the nurse apologetically provided a patient education leaflet. The physician let the topic go unmentioned.

These health care professionals clearly were not "into" managing weight issues in their patient population.

After reading this paper, who can blame them?  A review of fifteen randomized clinical trials involving over 4500 patients showed that while primary care-based "behavior change for weight loss" results in statistically significant weight loss, the average amount was a clinically insignificant 3 lbs.

While web sites such as this provide useful pointers on engaging patients on the topic of weight loss, the U.S. Preventive Services Task Force (PSPSTF) recommends that persons with obesity be referred to a care setting that specializes in intensive multi-component behavioral interventions.

The primary care PHB agrees: these frontline clinics can screen for obesity using height and weight, but that's where their responsibility arguably ends.  Until there is research that shows otherwise, the primary care setting is no place for management of weight issues.

The PHB's care was state-of-the-art.

DON’T BE ASHAMED OF YOUR STORY

For some reason hiding behind our secrets seems to be the easy and almost normal thing to do while we are journeying through life.  Don’t be ashamed of your story because you just might inspire or help someone going through the same things.  All people will experience life with circumstances that may or may not be within our control, and what we are learning from these experiences helps to create who we are.  Why do we get so caught up in what people may think that hiding our true self along with our struggles for fear of rejection is more important than sharing who we are and what is happening within our life. Fear takes over our ability to own our life, robs us of our comfort level to share those things that are important, those things that we struggle with, what we may need help with, and sadly cuts off any chance of gaining a support system through difficult times.

In my lifetime, I have hidden my inability to set boundaries and allowed myself to be mistreated in early marital and boyfriend relationships. I have been a closet Christian, suffered alone with anxiety, hid my cervical dystonia condition, and in my competitive fitness hid behind a ripped body as being healthy.  I look back and can see that my fear of rejection kept me from being me.  During the time of my inability to set boundaries, I cared more about what people would think or say than my own health. I never wanted to be considered a failure. I am embarrassed to say that at one point, I did not confess to being a Christian, and just kept it between me and God.  I was so uneasy about having cervical dystonia and the embarrassment of the tremor that can accompany the condition that I did not feel normal and fearful of being the girl that gets pointed at with the whispers behind the back. Having anxiety in my life has sucked and thinking that others would not understand kept me from opening that box as well.

That was years ago, and my journey of accepting myself and sharing who I am really and truly has been such a relief and freeing experience, and has allowed me to help so many suffering the same ways that I have.  I am not saying that it has been an easy road, or something that happens overnight, and I am a firm believer in faith and a positive advocate for a great therapist to assist during difficult times.  Learning to love yourself and share your story is not only a healing process, but also opens the door for others to feel comfortable enough to step toward you for help.  When fear is set aside and being “real” with who we are replaces that chain around our soul, be ready for doors to open and contentment to flood your life. 

So many hide behind relationship problems, eating disorders, medical conditions, drug and alcohol addiction, money problems, and the list can go on, that enjoying what it feels like to truly be happy is impossible.  When we live fake lives with fake smiles, and are so overcome by shame, embarrassment or fear it is no wonder why so many people suffer with depression and stress.  Hiding behind lies does not provide healing and positive growth in our lives and until we learn how to share our stories with courage, we will not be able to be happy healthy people.  We are required to own what and who we are and to become a better person than yesterday.  That will take courage and taking that first step to sharing your story will not only open the window to self-healing but also open the door to inspiring others.   

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Stay Healthy,

Darla

DARLA LEAL, FIT AT 50